Factors affecting the accuracy and safety of computed tomography-guided biopsy of intrapulmonary solitary nodules ≤30 mm in a retrospective study of 155 patients

Zhao,Gang; Shi,Xiaobao; Sun,Wei; Liang,Hongyuan; Mao,Xiaonan; Wen,Feng; Shan,Ming; Wang,Xihai; Lu,Zaiming

doi:10.3892/etm.2017.4179

May-2017 Volume 13 Issue 5

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May-2017 Volume 13 Issue 5

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Article

Factors affecting the accuracy and safety of computed tomography-guided biopsy of intrapulmonary solitary nodules ≤30 mm in a retrospective study of 155 patients

Authors:
- Gang Zhao
- Xiaobao Shi
- Wei Sun
- Hongyuan Liang
- Xiaonan Mao
- Feng Wen
- Ming Shan
- Xihai Wang
- Zaiming Lu
View Affiliations / Copyright

Affiliations: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China, Department of Radiology, The Fourth Hospital of China Medical University, Shenyang, Liaoning 110032, P.R. China
Pages: 1986-1992
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Published online on: March 2, 2017

https://doi.org/10.3892/etm.2017.4179
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Abstract

Computed tomography (CT)-guided percutaneous fine needle biopsy is a common method for lung biopsy. The objective of this study was to investigate factors affecting the accuracy and safety of CT-guided percutaneous lung biopsy of nodules ≤30 mm in diameter. Between January 2013 and March 2014, 155 patients underwent a CT‑guided percutaneous biopsy procedure on an intrapulmonary solitary nodule measuring ≤30 mm in diameter. Prospectively collected data were retrospectively reviewed and examined for the influence of clinical and pathological characteristics (age, gender, smoking status, adhesion of nodule to the pleura, puncture depth, nodule size and time of biopsy) on the accuracy of biopsy and incidence of pneumothorax and hemorrhage. The accuracy of CT‑guided biopsy was 90.3% (140/155). Biopsies predominantly contained lung adenocarcinoma (114/140; 81.4%) or squamous cell carcinoma of the lung (10/140; 7.1%). Accuracy was significantly dependent on nodule size, ranging in accuracy from 85 to 97% for patients with nodule diameters of ≤20 or 21‑30 mm, respectively (P<0.05). Pleural adherence of the nodule significantly increased the accuracy of the biopsy (P<0.05). Patients with a nodule of 11‑20 mm in diameter had a significantly higher incidence of pneumothorax compared with patients with a smaller nodule (P=0.013). In conclusion, the nodule size and adhesion to the pleura influenced the accuracy of CT‑guided biopsy of intrapulmonary nodules that were ≤30 mm in diameter. Nodule size may also affect the incidence of severe complications. CT-guided percutaneous lung biopsy has a high accuracy and is easy and safe to conduct for intrapulmonary solitary nodules of ≤30 mm in diameter.

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1	Wu CC, Maher MM and Shepard JA: Complications of CT-guided percutaneous needle biopsy of the chest: Prevention and management. AJR Am J Roentgenol. 196:W678–W682. 2011. View Article : Google Scholar : PubMed/NCBI
2	Nour-Eldin NE, Alsubhi M, Naguib NN, Lehnert T, Emam A, Beeres M, Bodelle B, Koitka K, Vogl TJ and Jacobi V: Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients. Eur J Radiol. 83:1945–1952. 2014. View Article : Google Scholar : PubMed/NCBI
3	Khan N, Jadoon H, Zaman M, Subhani A, Khan AR and Ihsanullah M: Frequency and management outcome of pneumothorax patients. J Ayub Med Coll Abbottabad. 21:122–124. 2009.
4	Lee IJ, Bae YA, Kim DG, Jung KS, Im HJ, Lee K, Lee Y and Bae SH: Percutaneous needle aspiration biopsy (PCNAB) of lung lesions: 5 years results with focusing on repeat PCNAB. Eur J Radiol. 73:551–554. 2010. View Article : Google Scholar : PubMed/NCBI
5	Sinner WN: Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn (Stockh). 17:813–828. 1976.PubMed/NCBI
6	Xu C, Hao K, Song Y, Yu L, Hou Z and Zhan P: Early diagnosis of solitary pulmonary nodules. J Thorac Dis. 5:830–840. 2013.PubMed/NCBI
7	Laspas F, Roussakis A, Efthimiadou R, Papaioannou D, Papadopoulos S and Andreou J: Percutaneous CT-guided fine-needle aspiration of pulmonary lesions: Results and complications in 409 patients. J Med Imaging Radiat Oncol. 52:458–462. 2008. View Article : Google Scholar : PubMed/NCBI
8	Li Y, Du Y, Yang HF, Yu JH and Xu XX: CT-guided percutaneous core needle biopsy for small (</=20 mm) pulmonary lesions. Clin Radiol. 68:e43–e48. 2013. View Article : Google Scholar : PubMed/NCBI
9	Hwang HS, Chung MJ, Lee JW, Shin SW and Lee KS: C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy: Usefulness in evaluation of small pulmonary nodules. AJR Am J Roentgenol. 195:W400–W407. 2010. View Article : Google Scholar : PubMed/NCBI
10	Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C and Sugimura K: CT-guided transthoracic needle aspiration biopsy of small (< or =20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 180:1665–1669. 2003. View Article : Google Scholar : PubMed/NCBI
11	Tsukada H, Satou T, Iwashima A and Souma T: Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR Am J Roentgenol. 175:239–243. 2000. View Article : Google Scholar : PubMed/NCBI
12	Khouri NF, Stitik FP, Erozan YS, Gupta PK, Kim WS, Scott WW Jr, Hamper UM, Mann RB, Eggleston JC and Baker RR: Transthoracic needle aspiration biopsy of benign and malignant lung lesions. AJR Am J Roentgenol. 144:281–288. 1985. View Article : Google Scholar : PubMed/NCBI
13	Khan MF, Straub R, Moghaddam SR, Maataoui A, Gurung J, Wagner TO, Ackermann H, Thalhammer A, Vogl TJ and Jacobi V: Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol. 18:1356–1363. 2008. View Article : Google Scholar : PubMed/NCBI
14	Tomiyama N, Yasuhara Y, Nakajima Y, Adachi S, Arai Y, Kusumoto M, Eguchi K, Kuriyama K, Sakai F, Noguchi M, et al: CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol. 59:60–64. 2006. View Article : Google Scholar : PubMed/NCBI
15	Choi JW, Park CM, Goo JM, Park YK, Sung W, Lee HJ, Lee SM, Ko JY and Shim MS: C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (</=20 mm) lung nodules: Diagnostic accuracy and complications in 161 patients. AJR Am J Roentgenol. 199:W322–W330. 2012. View Article : Google Scholar : PubMed/NCBI
16	Ng YL, Patsios D, Roberts H, Walsham A, Paul NS, Chung T, Herman S and Weisbrod G: CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less. Clin Radiol. 63:272–277. 2008. View Article : Google Scholar : PubMed/NCBI
17	Yeow KM, Su IH, Pan KT, Tsay PK, Lui KW, Cheung YC and Chou AS: Risk factors of pneumothorax and bleeding: Multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest. 126:748–754. 2004. View Article : Google Scholar : PubMed/NCBI
18	Winer-Muram HT: The solitary pulmonary nodule. Radiology. 239:34–49. 2006. View Article : Google Scholar : PubMed/NCBI
19	Remy-Jardin M, Remy J, Giraud F and Marquette CH: Pulmonary nodules: Detection with thick-section spiral CT versus conventional CT. Radiology. 187:513–520. 1993. View Article : Google Scholar : PubMed/NCBI
20	Berger WG, Erly WK, Krupinski EA, Standen JR and Stern RG: The solitary pulmonary nodule on chest radiography: Can we really tell if the nodule is calcified? AJR Am J Roentgenol. 176:201–204. 2001. View Article : Google Scholar : PubMed/NCBI
21	Li H, Boiselle PM, Shepard JO, Trotman-Dickenson B and McLoud TC: Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: Comparison of small and large pulmonary nodules. AJR Am J Roentgenol. 167:105–109. 1996. View Article : Google Scholar : PubMed/NCBI
22	Capalbo E, Peli M, Lovisatti M, Cosentino M, Mariani P, Berti E and Cariati M: Trans-thoracic biopsy of lung lesions: FNAB or CNB? Our experience and review of the literature. Radiol Med. 119:572–594. 2014. View Article : Google Scholar : PubMed/NCBI
23	Yamagami T, Iida S, Kato T, Tanaka O and Nishimura T: Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance: A better way to treat patients with lung nodules? AJR Am J Roentgenol. 180:811–815. 2003. View Article : Google Scholar : PubMed/NCBI
24	Boskovic T, Stanic J, Pena-Karan S, Zarogoulidis P, Drevelegas K, Katsikogiannis N, Machairiotis N, Mpakas A, Tsakiridis K, Kesisis G, et al: Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis. 6:(Suppl 1). S99–S107. 2014.PubMed/NCBI
25	Yang HH, Liu JJ and Tang XH: Ultrasound-guided percutaneous biopsy of peripheral pulmonary lesions: Factors influencing success rate. Chinese Journal of Medical Imaging. 22:117–120. 2014.
26	Hwang HS, Chung MJ, Lee JW, Shin SW and Lee KS: C-arm cone-beam ct-guided percutaneous transthoracic lung biopsy: Usefulness in evaluation of small pulmonary nodules. AJR. 195:W400–W407. 2010. View Article : Google Scholar : PubMed/NCBI